The cerebral and ocular complications of anaemia and the probable relationship of these to thrombosis : an address delivered to the Medico-Chirurgical Society of Glasgow / by C. O. Hawthorne.

  • Hawthorne, C. O. (Charles Oliver), 1858-1949.
Date:
1909
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Licence: In copyright

Credit: The cerebral and ocular complications of anaemia and the probable relationship of these to thrombosis : an address delivered to the Medico-Chirurgical Society of Glasgow / by C. O. Hawthorne. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    example of double optic neuritis and an ocular paralysis occurring in a patient free from evidences of disease other than aneemia, and that these two symptoms must find in intra- cranial thrombosis their clinical and pathological explanation Hence it would seem not only that double optic neuritis and an ocular paralysis may be numbered among the clinical events possibly attendant upon intracranial thrombosis, but also that they may appear as the only evidences of this' con- dition. This conclusion brings such case-records as the two just quoted into a natural relationship with the more extreme examples of cerebral disturbance to which reference has already been made, and in a certain number of which intra- cranial thrombosis has been demonstrated on necropsy. The suggestion, in short, is that the difference between the two groups is merely one of degree, and that both groups own a common cause in the shape of thrombosis affecting the cerebral veins and sinuses. This position is further strengthened by the fact that experiences intermediate between the two extremes are by no means wanting. There are well-authenticated cases of -anaemia in which the patients have been attacked more or less suddenly by severe headache, pains in the neck, and vomiting, together with optic neuritis and ocular paralysis. It is common to suggest that the intracranial condition responsible for these symptoms is a localised and transient meningitis, or an oedema of the brain, though positive evidence in support of either of these views is difficult to find. On the other hand, thrombosis will cover all the facts, and, if allowed, will permit the construction of a graded series of cases, occur- ring in anaemic patients, characterised by more or less severe ■evidences of cerebral disturbance, and finding in intracranial blood-clotting a common bond of interpretation. At one extreme are fatal cases with such symptoms as coma, delirium, various paralyses, and sometimes, optic neuritis, and proved by necropsy to be dependent on intracranial thrombosis; next come examples of less severe but still considerable cerebral disturbances, including optic neuritis, and having a favourable termination, the diagnosis of intracranial thrombosis being confirmed by the occurrence of thromboses in the jugular, femoral, or other veins; succeeding these may be placed cases of unusually violent headache and vomiting, with optic neuritis and an ocular paralysis ; and after these fall those cases of anaemia in which optic neuritis and an ocular paralysis are the sole unusual events. The earlier members of this series are demonstrably dependent on thrombosis, whilst, as